{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T15:13:25Z","timestamp":1772118805779,"version":"3.50.1"},"reference-count":16,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2021,3,30]],"date-time":"2021-03-30T00:00:00Z","timestamp":1617062400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Medical Virology"],"published-print":{"date-parts":[[2021,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Here we analyze hospitalized andintensive care unit coronavirus disease 2019 (COVID\u201019) patient outcomes from the international VIRUS registry (\n                    <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"https:\/\/clinicaltrials.gov\/ct2\/show\/NCT04323787\">https:\/\/clinicaltrials.gov\/ct2\/show\/NCT04323787<\/jats:ext-link>\n                    ). We find that COVID\u201019 patients administered unfractionated heparin but not enoxaparin have a higher mortality\u2010rate (390 of 1012\u2009=\u200939%) compared to patients administered enoxaparin but not unfractionated heparin (270 of 1939\u2009=\u200914%), presenting a risk ratio of 2.79 (95% confidence interval [CI]: [2.42, 3.16];\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20094.45e\u221252). This difference persists even after balancing on a number of covariates including demographics, comorbidities, admission diagnoses, and method of oxygenation, with an increased mortality rate on discharge from the hospital of 37% (268 of 733) for unfractionated heparin versus 22% (154 of 711) for enoxaparin, presenting a risk ratio of 1.69 (95% CI: [1.42, 2.00];\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20091.5e\u22128). In these balanced cohorts, a number of complications occurred at an elevated rate for patients administered unfractionated heparin compared to patients administered enoxaparin, including acute kidney injury, acute cardiac injury, septic shock, and anemia. Furthermore, a higher percentage of Black\/African American COVID patients (414 of 1294 [32%]) were noted to receive unfractionated heparin compared to White\/Caucasian COVID patients (671 of 2644 [25%]), risk ratio 1.26 (95% CI: [1.14, 1.40];\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20097.5e\u22125). After balancing upon available clinical covariates, this difference in anticoagulant use remained statistically significant (311 of 1047 [30%] for Black\/African American vs. 263 of 1047 [25%] for White\/Caucasian,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u2009.02, risk ratio 1.18; 95% CI: [1.03, 1.36]). While retrospective studies cannot suggest any causality, these findings motivate the need for follow\u2010up prospective research into the observed racial disparity in anticoagulant use and outcomes for severe COVID\u201019 patients.\n                  <\/jats:p>","DOI":"10.1002\/jmv.26918","type":"journal-article","created":{"date-parts":[[2021,3,5]],"date-time":"2021-03-05T05:48:49Z","timestamp":1614923329000},"page":"4303-4318","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Healthcare disparities among anticoagulation therapies for severe COVID\u201019 patients in the multi\u2010site VIRUS registry"],"prefix":"10.1002","volume":"93","author":[{"given":"Christian","family":"Kirkup","sequence":"first","affiliation":[{"name":"nference, Inc. Cambridge Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Colin","family":"Pawlowski","sequence":"additional","affiliation":[{"name":"nference, Inc. Cambridge Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arjun","family":"Puranik","sequence":"additional","affiliation":[{"name":"nference, Inc. Cambridge Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ian","family":"Conrad","sequence":"additional","affiliation":[{"name":"nference, Inc. Cambridge Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John C.","family":"O'Horo","sequence":"additional","affiliation":[{"name":"Mayo Clinic Rochester Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dina","family":"Gomaa","sequence":"additional","affiliation":[{"name":"University of Cincinnati Cincinnati Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Valerie M","family":"Banner\u2010Goodspeed","sequence":"additional","affiliation":[{"name":"Beth Israel Deaconess Medical Center Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jarrod M","family":"Mosier","sequence":"additional","affiliation":[{"name":"Banner University Medical Center Tucson Arizona USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Igor Borisovich","family":"Zabolotskikh","sequence":"additional","affiliation":[{"name":"Kuban State Medical University Krasnodar Russia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Steven K.","family":"Daugherty","sequence":"additional","affiliation":[{"name":"Cox Medical Center Springfield Missouri USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael A.","family":"Bernstein","sequence":"additional","affiliation":[{"name":"Stamford Health Stamford Connecticut USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Howard A.","family":"Zaren","sequence":"additional","affiliation":[{"name":"St. Joseph's Candler Health System Savannah Georgia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6047-5559","authenticated-orcid":false,"given":"Vikas","family":"Bansal","sequence":"additional","affiliation":[{"name":"Mayo Clinic Rochester Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brian","family":"Pickering","sequence":"additional","affiliation":[{"name":"Mayo Clinic Rochester Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew D.","family":"Badley","sequence":"additional","affiliation":[{"name":"Mayo Clinic Rochester Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rahul","family":"Kashyap","sequence":"additional","affiliation":[{"name":"Mayo Clinic Rochester Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A. J.","family":"Venkatakrishnan","sequence":"additional","affiliation":[{"name":"nference, Inc. Cambridge Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7434-9211","authenticated-orcid":false,"given":"Venky","family":"Soundararajan","sequence":"additional","affiliation":[{"name":"nference, Inc. Cambridge Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,3,30]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.21292\/2078-5658-2020-17-4-14-22"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40256-020-00420-2"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11886-020-01292-3"},{"key":"e_1_2_9_5_1","unstructured":"National Institutes of Health. NIH ACTIV initiative launches adaptive clinical trials of blood\u2010clotting treatments for COVID\u201019. 2020.https:\/\/www.nih.gov\/news-events\/news-releases\/nih-activ-initiative-launches-adaptive-clinical-trials-blood-clotting-treatments-covid-19"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/CCE.0000000000000113"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehm224"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1467-6419.2007.00527.x"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0081045"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2020.05.001"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood.2020006941"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/jth.14817"},{"key":"e_1_2_9_13_1","article-title":"Enoxaparin is associated with lower rates of thrombosis, kidney injury, and mortality than Unfractionated Heparin in hospitalized COVID patients","author":"Pawlowski C","year":"2020","journal-title":"medRxiv"},{"key":"e_1_2_9_14_1","unstructured":"United States Food and Drug Administration. HEPARIN SODIUM for intravenous use.https:\/\/www.accessdata.fda.gov\/drugsatfda_docs\/label\/2017\/017029s140lbl.pdf"},{"key":"e_1_2_9_15_1","unstructured":"United States Food and Drug Administration. Lovenox (enoxaparin sodium injection) for subcutaneous and intravenous use.https:\/\/www.accessdata.fda.gov\/drugsatfda_docs\/label\/2009\/020164s085lbl.pdf"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eclinm.2020.100404"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annepidem.2020.06.010"}],"container-title":["Journal of Medical Virology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jmv.26918","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/jmv.26918","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jmv.26918","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,7,9]],"date-time":"2024-07-09T01:45:11Z","timestamp":1720489511000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jmv.26918"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,3,30]]},"references-count":16,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2021,7]]}},"alternative-id":["10.1002\/jmv.26918"],"URL":"https:\/\/doi.org\/10.1002\/jmv.26918","archive":["Portico"],"relation":{"has-preprint":[{"id-type":"doi","id":"10.1101\/2020.11.06.20226035","asserted-by":"object"}]},"ISSN":["0146-6615","1096-9071"],"issn-type":[{"value":"0146-6615","type":"print"},{"value":"1096-9071","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,3,30]]},"assertion":[{"value":"2020-11-17","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-03-01","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-03-30","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}